EVALUATION OF 6 TUMOR-MARKERS IN PATIENTS WITH CARCINOMA OF UNKNOWN PRIMARY

We have retrospectively evaluated six serum tumor markers in 85 patien ts with carcinoma of unknown primary. The serum levels of carcinoembry onic antigen (CEA), CA 19-9, CA 15-3, CA 125, beta-chorionic gonadotro pin (beta-HCG) and a-fetoprotein (AFP) were related with the histologi cal pattern (undifferentiated carcinoma or adenocarcinoma), the number and the site of metastases, as well as the response to chemotherapy a nd the patients' survival. More than 40% of the patients had increased serum levels of all six tumor markers, except of AFP which was found to be increased in only 17% of them. Increased levels of CA 19-9 were related to metastatic adenocarcinoma, whereas CA 19-9 and CA 15-3 had a relationship with more advanced disease. Patients with liver involve ment had higher mean levels of CEA and CA 19-9 as compared to those wi th nodal disease. None of these markers was found to have a predictive value for response to chemotherapy or survival. Although the present study has a retrospective nature, it allows us to conclude that patien ts with CUP have a nonspecific over-expression of the above serum tumo r markers and that routine use of these markers does not offer any dia gnostic or prognostic assistance. (C) 1994 Wiley-Liss, Inc.